Professor Debruyne reported that in September 2004 the first private urogenital men's health institute for the aging male opened in Arnhem, The Netherlands. The objective of this initiative is to provide adequate early diagnosis and treatment of urogenital dysfunctions associated with male aging. Five different programs are offered each aiming at ensuring a higher quality of life:

- (early) Diagnosis of prostate cancer
- (early) Diagnosis and treatment of LUTS/BPH
- (early) Diagnosis and treatment of ED
- (early) Diagnosis and treatment LOH
- Lifestyle advice

In the first year of its existence 1,715 men with concerns or questions about their urogenital function visited Andros. They all followed the same intake and evaluation program, which consists of 4 questionnaires (IEEF, IPSS, ADAM and SF36 QoL) full blood (including PSA, testosterone and cholesterol) and urine evaluation, physical examination (including DRE and RR), flowmetry, PVR and, in selected cases prostate biopsy, UDO or UCS. Moreover, an extensive urogenital function interview-analysis was performed by a dedicated nurse practitioner. In a two-hour session each client is fully examined and analyzed.

In 161 (9.7%) men prostate cancer was diagnosed. In 796 (45.2%) men (symptomatic) BPH was diagnosed. ED was the main complaint in 355 (21.3%) men. 23% of their patients suffered from the combination of ED and LUTS whereas in 11.2 % of the men LOH was diagnosed. Treatment was only administered according to the guidelines of the EAU (and ISSAM).

The first year experience highlights the critical role men's health institutes and urologists offer in providing optimal care and advice to diagnose and treat from early stage urogenital dysfunctions in the aging male.

Urological Research Society Meeting, Salzburg Austria, September 7-10, 2006

By Christopher P. Evans, M.D.

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